TANGO2 Story and Picture Form
Please complete this form to share your TANGO2 story and/or your child's photo. At the end you can select which ways you give permission for this information to be shared.
Name
First Name
Last Name
Email
example@example.com
Childs Name
*
First name only
Childs Age
Location
State and/or country
Tell us about your child. Include details about their personality and favorite things.
Tell us about your child's TANGO2 story. (first symptoms, challenges, journey towards a diagnosis, hopes and dreams)
How can we share your story? Please check all that apply.
*
TANGO2 Research Foundation Facebook page (public) and TANGO2 Disease Family Facebook group
TANGO2 Research Foundation Website - Our stories page (public)
TANGO2 Research Foundation promotional materials such as fliers, posters, slide-decks etc. (public)
I would be willing to make a video recording of my TANGO2 story to be used to promote awareness of TANGO2 Disease. (A committee member will contact you with more details if you are interested.)
Pictures:
You can upload 1-3 images to go with your TANGO2 story.
Image 1
Browse Files
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of
Image 2
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of
Image 3
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of
Submit
Should be Empty: